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Int J Infect Dis. 2017 May;58:27-36. doi: 10.1016/j.ijid.2017.02.016. Epub 2017 Mar 9.

Dengue virus serological prevalence and seroconversion rates in children and adults in Medellin, Colombia: implications for vaccine introduction.

Author information

1
Dengue Vaccine Initiative, International Vaccine Institute, SNU Research Park, 1 Gwanak-ro, Gwanak-gu, Seoul, 151-742, South Korea; Department of Epidemiology, Biostatistics and Occupational Health, McGill University, Montreal, Quebec, Canada. Electronic address: mcarabali@ivi.int.
2
Dengue Vaccine Initiative, International Vaccine Institute, SNU Research Park, 1 Gwanak-ro, Gwanak-gu, Seoul, 151-742, South Korea.
3
Program for the Study and Control of Tropical Diseases, Universidad de Antioquia, Medellín, Colombia.
4
Department of Epidemiology, Biostatistics and Occupational Health, McGill University, Montreal, Quebec, Canada.
5
Program for the Study and Control of Tropical Diseases, Universidad de Antioquia, Medellín, Colombia; Department of Pathobiological Sciences, University of Wisconsin, Madison, Wisconsin, USA.

Abstract

BACKGROUND:

Dengue is an important public health problem worldwide. A vaccine has recently been licensed in some countries of Latin America and Asia. Recommendations for dengue vaccine introduction include endemicity and a high serological prevalence of dengue in the territories considering its introduction.

METHODS:

A community-based survey was conducted to estimate dengue seroprevalence and age-specific seroconversion rates in a community in Medellin, Colombia, using a dengue serological test (IgG indirect ELISA). Residents were selected at random and were first screened for dengue infection; they were then followed over 2.5 years.

RESULTS:

A total of 3684 individuals aged between 1 and 65 years participated in at least one survey. The overall dengue seroprevalence was 61%, and only 3.3% of seropositive subjects self-reported a past history of dengue. Among dengue virus (DENV)-naïve subjects with more than two visits (n=1002), the overall seroconversion rate was 8.7% (95% confidence interval 7.3-10.4) per 1000 person-months, over the study period. Overall, the mean age of DENV prevalent subjects was significantly higher than the mean age of seroconverted subjects. Specifically, DENV seropositivity over 70% was observed in participants over 21 years old. Serotype-specific plaque-reduction neutralization tests (PRNT) revealed that all four dengue serotypes were circulating, with DENV4 being most prevalent.

CONCLUSIONS:

These laboratory-based findings could inform dengue vaccine decisions, as they provide age-specific seroprevalence and seroconversion data, evidencing permanent and ongoing dengue transmission in the study area. This study provides evidence for the existing rates of secondary and heterotypic responses, presenting a challenge that must be addressed adequately by the new vaccine candidates.

KEYWORDS:

Colombia; Dengue; Dengue burden; Dengue prevalence; Dengue seroconversion; Serological survey

PMID:
28284914
PMCID:
PMC5421161
DOI:
10.1016/j.ijid.2017.02.016
[Indexed for MEDLINE]
Free PMC Article

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